The esophagus is an organ which consists of a muscular tube (10-13 inc. long) and connects the throat (pharynx) to the stomach. When a person swallows, the walls of the esophagus contracts to push food down into the stomach.
Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and facilitates swallowing. The top part of the esophagus has a special area of muscle at its beginning that relaxes to open the esophagus when it senses food or liquid coming toward it. This muscle is called the upper esophageal sphincter. The lower part of the esophagus that connects to the stomach is called the gastroesophageal junction (GE junction). There is a special area of muscle near the GE junction called the lower esophageal sphincter which controls the movement of food from the esophagus into the stomach and it keeps the stomach’s acid and digestive enzymes out of the esophagus.
Diseases and surgical procedures
The most common problem with the esophagus is reflux or gastroesophageal reflux disease (GERD). It happens when the gastroesophageal junction does not close properly. This allows stomach contents to reflux into the esophagus and irritate it. Treatment depends on the problem. Some get better with over-the-counter medicines or changes in diet, while, others may need prescription medicines or antireflux surgery.
Another desease of the esophagus is Achalasia, a disorder characterized by a progressive inability to swallow solids and liquids. The surgical treatment for achalasia is the Heller myotomy.
Other problems include cancer (squamous cell carcinoma and adenocarcinoma) treated surgically by esophagectomy.
Robotic-Assisted antireflux surgery
Laparoscopic antireflux surgery is the most recent treatment advancement for GERD when medications are not successful. Laparoscopic antireflux surgery is a minimally-invasive procedure that corrects gastroesophageal reflux by creating an improved valve mechanism at the bottom of the esophagus. Nonetheless, the laparoscopic approach has well-known disadvantages and limitations. For that reason, surgeons, in an effort to eliminate some of the impediments of laparoscopic surgery have adopted robotic assistance as a suitable alternative. Robotics has provided new technology, which allows laparoscopic surgeons to perform these advanced procedures with more accuracy, finer detail, and less difficulty.
Robotic-Assisted Total esophagectomy
Esophagectomy (removal of all or part of the esophagus) is the treatment of choice for esophageal cancer either as a therapy for the cancer itself or as a way to relieve symptoms, especially difficulty swallowing. Surgery for esophageal cancer is technically demanding operation and carries risks. Traditional (open) surgery involves an incision in the abdomen (laparotomy) and an incision on the side of the chest spreading the ribs (thoracotomy). Increasing experience with laparoscopic procedures has lead to its use in the dissection of the esophagus for total esophagectomy. Surgeons have extended the applications of the robotic system for the treatment of esophageal cancer in selected patients decreasing blood loss, postoperative pain, hospital stay and mortality.
Robotic-Assisted Heller myotomy for esophageal achalasia
Achalasia is a disorder of the esophagus characterized by a progressive inability to swallow solids and liquids. Surgical treatment has become the treatment of choice and offers long-term symptomatic relief to those who have the disorder. This surgical procedure (Heller myotomy) destroys the muscles at the gastroesophageal junction, allowing the valve between the esophagus and stomach to remain open. Laparoscopic surgery is less invasive, reduces the pain and postoperative recovery time, and is correlated with shorter hospitalization. In 2000, with the advent of robotics, surgeons switched from the conventional laparoscopic approach to the robotically-assisted Heller myotomy. The robotic system is ideally suited for advanced esophageal surgery, and has shown to be as effective as laparoscopic surgery with fewer complications.
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The esophagus is an organ which consists of a muscular tube (10-13 inc. long) and connects the throat (pharynx) to the stomach. When a person swallows, the walls of the esophagus contracts to push food down into the stomach.